Write ups and feeling bulling by staff

[Elan84]

Hello Nurses, I need some words of hope and some inputs from some good experience Nurses now that at work I really can't trust anyone.

I have been having a really tough time at work, I work at night and I am in total control of this charge Nurses that don't do nothing but report everything you do to make you drawn. I recently receive my first write up on December 30th blaming me that I discharge a patient and in the papers given there were other peoples papers in it, I work in the ED.

In the ED sometimes the charge Nurses discharge the patients and then ask you to chart the discharge for them, well as a rookie first lesson learn I won't never do it again. As an addendum the write up included that lab wrote me up for sending the Urine and vial of blood together in the same bag, blame I took with pride I won't never do it again. The lack of techs and the help provided because I am a new nurse is minimal and I screw up. This is my first write up and I took it as a learning experience, after all I hope it would be the worst of my mistakes and I did not kill anyone.

Then February 2nd another phone call from management, I am always so afraid, because really not having a good time and I don't feel comfortable with the staff any question I ask or movement I do gets reported by charge nurse and is very very intimidating. Well this second write up is what I want guidance from you experience nurses. I really feel they are picking on me to get me fire just because I don't know why they just don't like me.

The situations presented to me are the following:

- On January 29th, 2015 at 0645 (6:45am) I received a patient complaining of chest pain and complications.

- At 6:45am I received the patient and placed her in a room, initiated triage and placed her in a gown.

- Although my shift ended at 0700(7:00am), I finalized caring for the patient by ensuring protocol was met and placing the patient on a cardiac monitor at 0704 (7:04am) as documented in the chart.

- After placing her on the monitor and based on her condition, she was complaining about chest pain and palpitations, for that reason I delegated the ED technician to perform an Electrocardiogram on the patient and followed up with him to make sure it was done.

- At 0715 (7:15am) I handed off Report at bedside to the day Nurse on duty. At this point my duty ended and the respective patient was in a stable condition. There was no complaint presented to me at this time.

Based on the given facts above, I believe that I have completed my duties as an RN in full and with a professional and timely manner towards the respective patient.

Then on February 2nd, I received a phone call from my Manager, asking me to come to her office to discuss the presented scenario with me. Manager and (Chief Director of the ER) said the patient in question presented to the ER on January 29th at 0645 is a RN and is claiming that I did not place her on a monitor in timely manner. I explained with facts, based on my chart that I performed all my duties on timely manner, even though my shift already ended. I also explained that I handed off the report at bedside. If the monitor wasn't placed in a timely manner, then it would have been corrected at this time.

I still were forced to sign this write up that in top of that had the issue with the urine and the blood one more time and as explained by the manager was because at the time of the first write up the ESRM report was not ready and because now is it needed to be address again and really makes it sound like I did it twice when I just did it once.

Now I texted my manager this morning telling her I want the copy of this disciplinary actions I sign and she very mean reply check with HR you can have those copies but you are not allowed to take any patient information outside the hospital big big accusation ;-/ very very scared I have been crying and feeling very sad thinking I chose the wrong profession after working so hard to get here... any thought experience nurses ???

[Elan84]

i undressed the patient and by 0715 everything was done including the IV line, Ekg and cardiac monitor and my charting was done with the triage that I had to fo because there was no triage nurse present

[Elan84]

Tech? lol we have one tech for the whole ER, and no triage nurse, the 15 min triage, undress, IV line, EKG and IV line sounds great If I could only multiply myself x 4 and see all my 4 patient and new patient at the same time :-)

[psu_213, BSN, RN]

No one is telling you that you are a horrible nurse. The urine/blood thing is a bit petty. I send the two in the same bag all the time. Perhaps you hospital policy is to send them separately--in which can, you should be reminded of the policy, but I think reprimanding you for it is a bit much.

Unfortunately, I don't think you will like what I have to say about the chest pain. Based on your description earlier, the pt. got there at 0645, and it was not until after 0700 that the pt had and EKG done and was put on the monitor. In my ER, the nurse would get a email to explain his/herself re: EKG time. If his/her answer for why the EKG was delayed that long, that nurse will be counseled…maybe not "written up" per se, but that nurse is going to get a talking to. Again, I don't think you a horrible nurse, but I do think it warranted some form of action. And if there is no tech present, the nurse must get the EKG.

[Elan84]

I am a new nurse and I have two and only two chage nurses for night and both are lazy and unfair, lately I get all patient while all other nurses aren't busy... and that morning I had to do all for the patient, I gave handoff report at0715 at bedside and acording to my charting patient was on the monitor, the complaint came after i left that patient was never in the heart monitor, in that case Day nurse should of addressed at bedside at time of report right?. In my hospital pTients have to take monitors completely when they go to tge bathroom or testing, many thing could happened After i left my shift, I wasn't there to see who was right, but day nurse washed her hands with my name :-(.

[psu_213, BSN, RN]

I gave handoff report at0715 at bedside and acording to my charting patient was on the monitor, the complaint came after i left that patient was never in the heart monitor, in that case Day nurse should of addressed at bedside at time of report right?

I thought the complaint by the pt. was that she was not on the monitor soon enough? Based on your timeline, that seems to be a valid complaint. Again, based on the timeline, she was on the monitor when the dayshift nurse was there...so what was to be addressed? I know this all sounds harsh, but part of becoming a better nurse is acknowledging mistakes, learning from them, and changing you practice based on that. At this point, you don't seem willing to acknowledge your mistake here. I am confident that you can be a great nurse, but you need to recognize what you did wrong and how to make it better before you can be a great nurse. Own the mistakes, improve, and grow from there!

P.S., I'm not going to address the charge nurse issues at this point. I don't know them, I don't know your ER, and I don't know if there is a good reason they are giving you patients while other nurses appear not to be busy. I have been on the charge nurse side of things, and there may be more to the situation than you know.

[CTnewgrad826]

I'm sorry this happened to you and you feel you were thrown under the bus by your peers. However I just wanted to point out it seems you're blaming the day shift nurse that was coming on in a sense. I don't have ED experience but on the floor I know if I have a patient come up at 645 they are my patient. I am orienting to the room and taking care of their potential chest pain complaint. I don't care if my shift ends at 700. I'm in there getting the EKG, hooking them up to tele, calling the MD, etc etc. The new nurse coming on knows nothing about this patient. They help out where they can but I am in control until the situation is stable enough for me to step out of the room and report off to the oncoming nurse. From there the oncoming nurse is now responsible for this patient. You also better believe I am writing the note on exactly what happened and what interventions were done even though my shift is technically over.

Now I can see that you did stay beyond your shift to help out and initiate the cardiac work up, however from what you describe it doesn't really sound like you "completed" what you should've, it sounds like you got the EKG, hooked them up to the monitor and then passed the patient off. In my opinion this is probably why the oncoming nurse may (or may not, you don't have proof who reported what) have "thrown you under the bus." They honestly probably weren't even throwing you under the bus, they probably were trying to explain to management what happened and were unable to give much information without mentioning what you had done for the patient and reported to them about the patient.

It's possible your peers are "bullying" you, but I don't gather that from the information you provided. It sounds like they were trying to their job just as you were. Unfortunately you were called out not because you are new but because new nurses make mistakes and clearly mistakes were made. Take it in stride and learn from it. You weren't fired, everyone make mistakes. Instead of blaming everyone else look at the situation and figure out what you could've done and what you will do next time. Good luck!

[Libby1987]

More lazy nurses?

[psu_213, BSN, RN]

I'm sorry this happened to you and you feel you were thrown under the bus by your peers.

The thing is, she was not thrown under the bus by anyone, let alone her coworkers. For a patient with chest pain, EKG comes first. Our goal is 5 minutes or less. Even if there are no ST elevations, the pt still may be having a cardiac event. The #1 early complication of an MI? Arrhythmias. So the pt. must get on a monitor. It was the OP's charting, combined with a patient "complaint" (a quite justified complaint), that did her in…not the dayshift RN.

[CTnewgrad826]

Exactly what I stated in my post psu_213 ... just acknowledging the OP's feelings.

[Elan84]

I want to be clear, my patient WAS on the monitor when I left. physically and in chart. The management is not questioning timing, is saying patient was not on the monitor. But all this happened after I was gone, day nurse got bed side report, and she notice patient in monitor that's why she had nothing to do at this time. Later she forgets to put patient in monitor and is easier to blame into night nurse who was only with patient for 15 min

[CTnewgrad826]

I'm confused...if the patient was on the monitor how were they suddenly not on it when you left?

And your original post stated the complaint was timing not the monitor. You need to be more clear with the details of what happened if you want effective advice.

[PMFB-RN, RN]

They are creating a paper trail so they can fire you. Wise up and quite before you are fired.